High Daily Drinking Increases Risk of Metabolic Syndrome

Action Points

Explain to interested patients that most studies of the effects of alcoholic consumption focus on the volume of alcohol consumed.

Note that this study, which focuses on drinking patterns, finds that excessive drinking increases the risk of the metabolic syndrome.

ATLANTA, July 30 -- Consuming more alcohol than recommended by U.S. Dietary Guidelines -- more than two drinks a day for men and more than one for women -- increases the risk of metabolic syndrome by 60%, researchers here said.

The finding emerged from a study of alcohol consumption patterns among participants in the 1999-2002 National Health and Nutrition Examination Survey (NHANES), according to Amy Fan, M.D., Ph.D., of the CDC, and colleagues.

Earlier studies looking at the relationship between alcohol and the metabolic syndrome have focused on the volume of alcohol consumed and have shown both protective and detrimental effects, Dr. Fan and colleagues wrote in the October issue of the Journal of Clinical Endocrinology & Metabolism.

Such an approach "can obscure large differences in drinking styles" that may have important effects, the researchers said.

To examine the issue, they looked at metabolic abnormalities among current drinkers taking part in NHANES who had fasted for at least 12 hours before a blood test, who were not diagnosed with any cardiovascular disease, and who had not recently changed their drinking patterns in reaction to a medical condition.

All told, 1,529 participants met the criteria and had complete data available for evaluating both drinking patterns and the metabolic syndrome, the researchers said.

Measures of drinking patterns included:

Frequency, grouped as less than a day a week, one to two days a week, or three or more days a week

Usual quantity -- one, two, or more than three drinks per drinking day

Drinking exceeding the U.S. Dietary Guidelines -- men who had more than two drinks and women who had more than one drink in a day

Frequency of binge drinking (defined as more than five drinks in a day) -- none, less than once a week, and at least once a week during the previous 12 months

Dr. Fan and colleagues also studied drinking patterns in relation to a metabolic abnormality scale with categories of zero, one, two, and three or more abnormalities.

Analysis found that:

About 20% of men and 19% of women had the metabolic syndrome and 72% of men and 68% of women had at least one metabolic abnormality.

52% of men and 67% of women regularly exceeded the U.S. Dietary Guidelines.

Daily consumption that exceeded the guidelines was associated with a 60% increase in the risk of metabolic syndrome. The odds ratio was 1.60, with a 95% confidence interval from 1.22 to 2.11.

Drinking in excess of the guidelines was associated with an increased risk of all of the metabolic abnormalities, with the exception of low serum HDL cholesterol.

The prevalence of any past-year binge drinking was 52%.

Binge drinking at least once a week was associated with a 51% increase in risk of the metabolic syndrome. The odds ratio was 1.51, with a 95% confidence interval from 1.01 to 2.29.

The implication is that "most people who consume alcohol in the United States drink in ways that may increase their risk of the metabolic syndrome and related conditions," Dr. Fan said.

Prevention efforts should focus on reducing alcohol consumption, she said, but "unfortunately, few physicians screen their patients about alcohol use or are knowledgeable about guidelines that define low-risk or moderate drinking."

The researchers did not report any external support for the study. They reported no conflicts.

Reviewed by Robert Jasmer, MD Associate Clinical Professor of Medicine, University of California, San Francisco

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